Field of the invention
[0001] The invention relates to a method for manufacturing a medical product comprising
a hollow body, wherein at least part of a wall of the hollow body is coated at least
on the inside with a layer comprising a polymer.
Background of the invention
[0002] In many indications a medical product can be of advantage that comprises a hollow
body, such as a medical stent, the wall of the hollow body being coated with a polymer,
e.g. a polysaccharide such as chitosan.
[0003] A stent is a usually tubular object for insertion into a natural passage or conduit
of the body, e.g. a blood-vessel, to prevent or counteract a localized flow constriction
in said body passage or conduit. The wall of the stent often comprises a metal mesh,
e.g. from metal wire, or a perforated metal sheet. Most stents are expandable in the
sense that they can assume a compressed (or folded) state, in which they have a small
tube cross-section for insertion into the body passage, and an expanded (or un-folded)
state, which they can assume once introduced into the body passage and in which they
have a larger cross-section in order to press against the walls of the body passage.
The biocompatibility of medical products, in particular implantable medical products
such as the before mentioned stents, can be improved by covering or coating them with
a polymer, e.g. chitosan.
[0004] The polysaccharide chitosan is the N-deacetylated derivative of chitin, which can
be found widely in the exoskeletons of arthropods, shells, crustaceans and the cuticles
of insects. Chitosan, although naturally occurring in some fungi, is produced industrially
by alkaline hydrolysis of chitin. The different solubilities of chitin and chitosan
in dilute acids are commonly used to distinguish between the two polysaccharides.
Chitosan, the soluble form, can have a degree of acetylation between 0% and about
60%, the upper limit depending on parameters such as processing conditions, molecular
weight, and solvent characteristics. While soluble in acidic aqueous media, chitosan
precipitates at a pH of above 6.3.
[0005] Both chitin and chitosan are promising polymers for a variety of applications, including
water treatment (metal removal, flocculant/coagulant, filtration), pulp and paper
(surface treatment, photographic paper, copy paper), cosmetics (make-up powder, nail
polish, moisturizers, fixtures, bath lotion, face, hand and body creams, toothpaste,
foam enhancing), biotechnology (enzyme immobilization, protein separation, chromatography,
cell recovery, cell immobilization, glucose electrode), agriculture (seed coating,
leaf coating, hydroponic/fertilizer, controlled agrochemical release), food (removal
of dyes, solids and acids, preservatives, color stabilization, animal feed additive),
and membranes (reverse osmosis, permeability control, solvent separation). Of particular
interest are biomedical applications of chitin and chitosan because of their biocompatibility,
biodegradability and structural similarity to the glycosaminoglycans. Applications
and potential applications include wound dressings, tissue engineering applications,
artificial kidney membranes, drug delivery systems, absorbable sutures, hemostats,
antimicrobial applications, as well as applications in dentistry, orthopedics, ophthalmology,
and plastic surgery. For comprehensive reviews of potential applications of chitin
and chitosan see, for example
Shigemasa and Minami, "Applications of chitin and chitosan for biomaterials" 1997,
Biotech. Genetic. Eng. Rev. 1996, 13, 383,
Kumar, "A review of chitin and chitosan applications", React. Funct. Polym .2000,
46 (1), 1 and
Singh and Ray, "Biomedical applications of chitin, chitosan, and their derivatives",
J. Macromol. Sci. 2000, C40 (1), 69.
[0006] Due to its excellent biocompatibility, chitosan is a suitable candidate for biocompatible
coatings in the medical field, such as for devices in urological, cardiovascular,
gastrointestinal, neurological, lymphatic, otorhinolaryngological, ophthalmological
and dental applications. For example, chitosan's regenerative potential towards endothelial
cells (
Chupa et al.,"Vascular Cell Responses to Polysaccharide Materials: In Vitro and In
Vivo Evaluations", Biomaterials 2000; 21 (22), 2315) supports the formation of blood compatible layers when chitosan is applied to the
surface of cardiovascular implants (see
Thierry et al., "Biodegradable membrane-covered stent from chitosan-based polymers",
J. Biomed. Master. Res. 2005; 75A (3); 556). Chitosan's bacteriostatic potential leads to a significant reduction of the risk
of implant-related infections when applied as coating of vascular grafts (see
Fujita et al., "Inhibition of vascular prosthetic graft infection using a photocrosslinkable
chitosan hydrogel",J. Surg. Res. 2004, 121 (1), 135). Another advantage of chitosan coatings is the option to incorporate bioactive agents
such as cytostatic drugs which can be released in a controlled fashion (see
Chen et al., "The characteristics and in vivo suppression of neointimal formation
with sirolimus-eluting polymeric stents", Biomaterials 2009, 30 (1), 79).
[0007] As to the coating of hollow medical products with polymers, the article by Thierry
et al., supra, describes a method in which a metal stent is covered with a compact
film by casting a jelly-like solution containing chitosan and polyethylene glycol
onto the stent while the latter is rotated. The film covers the entire surface of
the mesh-like stent, i.e. not only the struts but also the spaces between them. The
latter can be disadvantageous as the chitosan layer between the struts may break when
the stent changes from the compressed into the expanded state.
[0009] In the
US-patent US 7,279,174 a method is described in which a mixture of a hydrophobic polymer and a hydrophilic
polymer such as chitosan is sprayed onto a stent in order to apply a chemically cross-linked
networks of these polymers. It may be a disadvantage of this prior art that cross-linking
and other modifications of chitosan can negatively affect the polymer's advantageous
properties, in particular its biocompatibility. The US-patent
US 7,255,891 suggests dipping a stent into a polymer solution such as a chitosan solution or spraying
it with that solution. Similarly, the US-patent
US 6,899,731 describes an experiment in which alternation layers of chitosan and DNA were applied
to a balloon catheter by means of spraying or dipping. It is suggested that such alternating
layers could also be applied to stents. The US-patent
US 6,555,225 discloses the formation of mechanically stable layers on a stent surface of a polyelectrolyte
complex that comprises a water-soluble polyion such as chitosan ionically cross-linked
to a water-insoluble polyion.
[0010] The US-patent
US 6,969,400 suggests applying to a synthetic implant such as a stent a mixture of chitosan and
two other polymer components forming a covalently cross-linked network. In the US-patent
US 7,351,421 a method is described in which a chitosan solution is applied to a stent, e.g. by
dip coating or spray coating, and a cross-linking agent is subsequently applied in
order to covalently cross-link the chitosan. The US-patents
US 6,923,996 and
US 7,390,525 describe a method in which first a reactive layer comprising a cross-linking agent
is applied on the surface of a medical device, such as a stent, followed by the application
of a solution comprising a drug and a cross-linkable polymer, such as chitosan. Finally,
the article by
Thierry et al. "Bioactive coatings of endovascular stents based on polyelectrolyte
multilayers", Biomacromolecules, 2003, 4 (6), 1564, describes a method in which a NiTi stent was first provided with a PEI primer layer
and then alternating layers of hyaluronan and chitosan.
[0011] The article by
Wu et al. "Voltage-dependent assembly of the polysaccharide chitosan onto an electrode
surface", Langmuir, 2002, 18 (22), 8620, and the article by
Fernandes et al. "Electrochemically induced deposition of a polysaccharide hydrogel
onto a patterned surface" Langmuir, 2003, 19 (10), 4058 describe the electro-deposition of chitosan on negatively charged electrodes in an
acidic aqueous chitosan solution. The US-patents
US 7,014749 and
US 7,387,846 disclose methods for electrolytically depositing a mixture of chitin and brushite
(a pre-cursor of hydroxyapatite) on a metallic prosthesis.
[0012] The international patent application
WO 01/014617 describes an electrodeposition method in which a stent acting as working electrode,
a reference electrode, and a counter-electrode are submerged in an electrolyte comprising
chitosan. It is suggested that radioactively labelled chitosan may be deposited on
the stent if the stent plays the role of the cathode. The inventors seek to exploit
the fact that the presence of radioactivity on the surface of the stent can reduce
the incidence of restenosis.
Problem to be solved by the inventions
[0013] It is an objective of the present invention to provide an improved method for manufacturing
a medical product comprising a hollow body, wherein at least part of a wall of the
hollow body is coated at least on the inside with a layer comprising a polymer.
Solution according to the invention
[0014] According to the invention, the problem is solved by a method for manufacturing a
medical product comprising a hollow body, wherein at least part of a wall of the hollow
body is coated at least on the inside with a layer comprising a polymer, wherein at
least the part of the inside of the wall of the medical product brought into contact
with a mixture, preferably a solution, of the polymer, and the polymer is electrodeposited
from the mixture on at least the part of the inside of the wall, and at least one
electrode is placed inside the hollow body, the inside electrode having the same polarity
as the hollow body.
[0015] According to the present invention, the deposition of the polymer is an electrodeposition;
in other words, the polymer is electrodeposited on the wall. Electrodeposition involves
the application of an electric current through the mixture by means of at least two
electrodes of opposite polarity. Further information on electrodeposition can be found
in the "
Handbook of nanophase and nanostructured materials" Vol. 1, "Synthesis" by Zhong Lin
Wang et al., Kluvers. In a suspension or colloid, the electrodeposition may more specifically be an electrophoretic
deposition (EPD).
[0016] According to the present invention at least one electrode is placed inside the hollow
body (inside electrode). The inventors have found that advantageously placing one
electrode on the inside of the hollow body can improve the electrodeposition of polymer
on the inside of the hollow body. The inside electrode has the same polarity as the
hollow body.
[0017] In the context of the present invention, "coated" with regard to the wall of the
hollow body means that the structural elements which make up the wall of the hollow
body are coated with the polymer, while any apertures which may be present in the
wall remain free. Apertures may occur e.g. if the wall is web- or mesh-like or from
an expanded or perforated sheet of material, which is often the case in medical stents.
In the case of a web- or mesh-like wall, the structural elements are the struts that
border the apertures. If, on the other hand, the wall is compact, i.e. of a single,
un-perforated piece, this piece is considered the wall's single structural element.
[0018] This is in contrast to a "covered" wall, which means that the wall is covered with
a compact polymer layer, very much like a tent's frame is covered by the fabric of
the tent. If a wall is "covered" by a polymer layer, the layer extends continuously
across the wall, including any apertures which may be present in the wall. Because
the compact layer extends across the apertures, the apertures in general will be closed
by a polymer film. Note that such apertures in the wall need to be distinguished from
openings in the medical product, such as the open end of a tubular stent. Reference
to a "covered wall" does not in any way imply that such openings in the medical product
also have to be covered by the polymer layer. In fact, quite to the contrary, these
openings in general are uncovered. As far as in the following it is referred to merely
a part of a wall rather than the entire wall, the above definition of the "coated"
as distinguished from "covered" applies correspondingly.
[0019] For example, a mesh-like medical stent that is embedded in a compact tube of polymer
with a polymer film extending across the apertures between the polymer-coated struts
can be referred to as "polymer-covered", while a mesh-like medical stent in which
a layer of polymer is only formed around the struts while keeping the apertures open
can be referred to as "polymer-coated". It is an achievable advantage of the invention
that due to the inside-coating of the medical product occlusions, including thrombosis,
of a natural passage or conduit of the body, e.g. a blood vessel, in which the medical
product is inserted, can be counteracted.
[0020] In the context of the present invention, the term "native chitosan" refers to the
detined chemical entity chitosan, which is a poly(N-acetyl-D-glucosamine-co-D-glucosamine)
copolymer. Any cross-linked or otherwise chemically moditied chitosan is considered
a chitosan derivative, having different properties than the native chitosan.
[0021] By coating rather than covering the wall of the medical product, it can advantageously
be avoided that the polymer layer fractures when the medical product changes its shape,
e.g. during an expansion of the kind that customarily occurs in a stent after it has
been inserted. Also, advantageously, the area of the polymer layer can be minimized,
thereby saving material and reducing adverse effects that can be induced by the presence
of a foreign object inside the human or animal body, such as the occlusion of a body
passage or conduit, including thrombosis and restenosis in a blood vessel.
[0022] It is an achievable advantage of the method according to the invention that a very
thin layer can be achieved, thereby saving material and allowing for particularly
flexible polymer layers. Moreover, particularly even polymer layers can be achieved
which may add to the anti-occlusive properties of the coating.
[0023] It is another achievable advantage of the invention that it is suitable for coating
hollow bodies from electro-conductive material, such as metal, with a polymer coating.
[0024] The invention advantageously can be applied to an implantable medical product such
as a medical stent, including drug-eluting medical stents. Advantageously, the medical
product may be applied in the medical treatment, e.g. in surgey or therapy or in diagnostic
methods, of an animal, e.g. a mammal, in particular a human. It can in particular
be applied to counteract an occlusion in a natural passage or a conduit of the animal
or human body, such as in the cardiovascular system (e.g., coronary stent), biliary
tract (e.g., biliary stent), gastrointestinal tract (e.g., esophageal stent), pulmonary
tract (e.g., tracheal stent), or urinary tract (e.g., ureteral stent, urethral stent).
Particularly advantageously, the medical product can be applied to prevent thrombosis.
[0025] It is an achievable advantage of the use of a citric acid-containing mixture in the
electrodeposition of a polymer that the polymer layer obtained is smoother as compared
to the prior art and/or pores in the layer can be avoided or at least reduced. While
this is particularly useful in the method according to the present invention of manufacturing
of the medical product, it is not limited to this application.
Preferred embodiments of the invention
[0026] In a preferred method according to the invention, the polymer precipitates from the
mixture to be deposited on at least the part of the inside of the wall. Preferably,
the medical product is at least partly immersed into the mixture of the polymer so
that the inside and the outside of the wall are in contact with the mixture and the
polymer is deposited from the mixture on at least the part of the inside and the outside
of the wall. More preferably, the polymer precipitates from the mixture to be deposited
on at least the part of the inside and the outside of the wall.
[0027] In a preferred embodiment of the invention, the wall of the hollow body is essentially
tubular, preferably with an oval or circular cross-section. The hollow body may e.g.
have the shape of a cylinder barrel, e.g. as typically in a cylindrical medical stent.
It may, however, also have other tubular shapes, e.g. the pigtail-shape of a ureteral
stent. The hollow body may also comprise several tubular branches, which may moreover
differ in their cross sections. A medical product of this kind may e.g. be advantageously
applicable as a branched medical stent.
[0028] The preferred medical product, more preferably the hollow body, has openings on its
ends. Thereby it is achievable that a fluid, e.g. a body fluid such as blood, bile
or urine, can flow through the medical product. The preferred medical product is a
stent or an angioplastic device, i.e. any device used for angioplasty, preferably
an angioplastic stent. Other preferred stents include biliary stents, esophageal stents;
tracheal stents, ureteral stents, and urethral stents.
[0029] Preferably, at least part of the wall of the hollow body is holey, more preferably
mesh- or web-like with apertures bordered by struts. In one preferred embodiment of
the invention, the wall is a perforated or expanded sheet of material, in another,
it is woven, e.g. from one or several strands of wire of material. The wall preferably
comprises more than 20, more preferably more than 50, more preferably more than 100
apertures. The cross-section of the apertures preferably is between 0.5 µm (micrometers)
and 5000 µm, more preferably between 10 µm and 2500 µm, more preferably between 50
µm and 1500 µm. The area of the solid part (i.e. the part made up by the structural
elements as opposed to the apertures) of the wall of the hollow body, e.g. area of
the struts in a mesh- or web-like wall, preferably is less than 75%, more preferably
less than 50%, more preferably less than 25% of the overall wall area.
[0030] A preferred material of the wall is an electro-conductive material. The wall may
be of a single material, preferably a metal or a metal alloy, or of several materials,
preferably arranged in layers. In the latter case, at least the outermost layer, which
layer is coated by the polymer according to the invention, preferably is of a metal
or of a metal alloy. Preferred metals include silver, gold, platinum, palladium, iridium,
osmium, rhodium, titanium, tungsten and ruthenium. Preferred metal alloys include
cobalt-chromium alloys, nickel-titanium alloys (e.g. nitinol), iron-chromium alloys
(e.g. stainless steel, which preferably contains at least 50% iron and at least 11.5%
chromium), cohalt-chromium-iron alloys (e.g. elgiloy alloys), and nickel-chromium
alloys (e.g. inconel alloys).
[0031] In one preferred embodiment of the invention, the coating comprises a single polymer,
more preferably it consists of this polymer. The invention, however, also encompasses
embodiments in which another substance, for example a biologically active substances
such as a drug, is incorporated into the polymer. This other substance may of course
also be a polymer. In a preferred embodiment of the invention, a metal or metal alloy,
e.g. from the above list of metal and metal alloys, is incorporated into the polymer.
Preferably, the mass fraction of the other substance to the total mass of the coating
is less than 50%, more preferably less than 10% more preferably less than 1%. In a
particularly preferred embodiment of the invention, the other substance is present
in the coating only in traces, i.e. the mass fraction of the other substance to the
total mass of the coating is less than 0.1%, more preferably less than 0.01%, more
preferably less than 0.001%. The other substance may be present in the form of nanoparticles,
i.e. particles with a diameter of less than 100 nanometres. The coating may of course
also comprise several of the other substances. It is an achievable advantage of the
presence of another substance or other substances in the coating that the medical
product can be rendered a drug-eluting medical product, e.g. a drug-eluting medical
stent. For example, a polymer coating comprising silver particles can release silver
ions, which are known to have antibacterial properties. Moreover, the other substance(s)
may provide the polymer layer with active groups to which further entities can attach.
[0032] Incorporation of the other substance may for example be achieved by providing the
other substance in the mixture from which the polymer is deposited. It is also possible
to introduce the other substance into the layer after the layer has already been formed,
e.g. by immersing the polymer-coated wall into a mixture, e.g. a solution, of the
other substance.
[0033] Alternatively or in addition, the medical product can be provided with a further
layer into which the other substance (s), preferably including one or more drugs,
are incorporated or which consists of the other substance(s). Again, this advantageously
can render the medical product a drug-eluting medical product, e.g. a drug-eluting
medical stent. The further layer preferably is applied before the polymer layer. The
further layer preferably is located under the polymer layer.
[0034] The preferred polymer according to the invention is a polysaccharide. The preferred
polymer is a biopolymer, i.e. a polymer that can be produced by a living organism.
Preferably the biopolymer is a polymer that is formed by biological polymerisation,
more preferably polymerisation of naturally occurring monomers. The polymer may be
hydrophobic or hydrophilic. The preferred polymer with which the wall is coated is
in its native form. In the context of the present invention, "native" with regard
to the polymer means in particular that the polymer is not cross-linked, neither with
itself nor with another polymer, chemically modified or chemically bound to another
material. Preferably, the polymer of the coating is not ionized. Moreover, when the
polymer is a biopolymer, it preferably is present in the coating in the form in that
it usually occurs in nature.
[0035] A preferred polysaccharide is native chitosan. It is an achievable advantage of this
embodiment of the invention that occlusions of the medical product can be avoided,
presumably due to the biocompatibility of the native chitosan, its regenerative potential
towards endothelial cells and/or its bacteriostatic potential. Moreover, advantageously,
bioactive agents such as drugs can be incorporated into the native chitosan coating.
[0036] Suitable non-native polymers include derivatives of chitosan, e.g. partially or fully
N-, O-, or N,O-derivatized chitosan, including derivatives capable of forming a positive
charge such as those bearing amine, guanidinium, imidazole, indole, purine , pyrimidine,
pyrrole, etc. funtionalities, as well a derivatives capable of forming a negative
charge such as those hearing alkoxide, carboxyl, carboxylate, hydroxy acid, phenolic,
phosphate, sulfhydryl, etc. functionalities. Other suitable polymers include polysaccharides,
polypyrrols, polyamines, polyimines, polypeptides, polyamino acids, polycarboxylic
acids as well as other polymers and polymer derivatives capable of forming a positive
or negative charge.
[0037] In a preferred medical product according to the invention, the entire wall is coated
with the polymer, at least on one side, preferably on both sides.
[0038] In a preferred medical product, at least a section of the wall, preferably the entire
wall, is coated on both sides with the polymer layer such that the coating continuously
extends from the inside to the outside of the hollow body. In other words, there is
no un-coated gap between the outside and the inside coating of the (part of the) wall
of the hollow body. Preferably, the coating will extend from the inside to the outside
of the hollow body through the apertures in the wall.
[0039] In a preferred medical product, at least some of the one or more structural elements
which make up the wall of the hollow body will be entirely coated with the polymer
layer. In this context, "entirely coated" means in particular that if a structural
element has a part on the inside and another part on the outside of the hollow body,
there is no gap between the coating of the structural element on the inside part and
the coating of the structural element on the outside part. Rather, the coating continuously
extends on the structural element from the inside to the outside of the hollow body.
Preferably all of the structural elements which make up a section, more preferably
all structural elements which make up the entire wall of the hollow body, will be
entirely coated with the polymer layer.
[0040] In a preferred method according to the invention, at least the entire inside of the
wall of the medical product is brought into contact with the mixture of the polymer
and the polymer precipitates from the mixture to be deposited at least on the inside
of the wall. It is an achievable advantage of this embodiment of the invention that
the entire wall of the hollow body is coated at least on the inside with the polymer.
[0041] In a preferred method according to the invention, the medical product is at least
partly, more preferably entirely, immersed into a mixture of the polymer so that the
inside and the outside of the wall are in contact with the mixture and the polymer
precipitates from the mixture in order to be deposited on at least the part of the
inside and the outside of the wall. It is an achievable advantage of this embodiment
of the invention, that the wall of the hollow body can be polymer-coated both on the
inside and the outside, preferably simultaneously.
[0042] The thickness of the coating may be the same on the inside and the outside or the
thickness on the inside is different to that on the outside. If the thicknesses are
different, the inside coating preferably is thicker than the outside coating. Preferably,
the thickness of the polymer coating on the inside of the hollow body is between 0.02
µm and 2000 µm, more preferably between 0.2 µm and 200 µm, more preferably between
0.5 µm and 10 µm. The preferred thickness of the polymer coating on the outside of
the hollow body is between 0.02 µm and 2000 µm, more preferably between 0.2 µm and
200 µm, more preferably between 0.5 µm and 10 µm.
[0043] In the context of the present invention, the "thickness" of the coating is measured
in the direction perpendicularly to the surface of the coated structural element.
It is an achievable advantage of the invention that very even coatings can be achieved.
In particular, accumulations of coating polymer that extend from the structural elements
into the apertures can be avoided, such as accumulations that have the shape of webbings
that extend from struts of a web- or mesh-like wall into the apertures surrounded
by the struts. According to the present definition of "thickness", the parts of the
structural elements from which these accumulations extend would have a much thicker
coating than the surrounding parts. In contrast to this, in a preferred embodiment
of the invention the difference in thickness between a local minimum and an adjacent
local maximum of thickness on the same side of the hollow body is less than 100%,
more preferably less than 30%, more preferably less than 10%, more preferably less
than 3%, more preferably less than 1% of the average thickness of the polymer layer
on this side of the hollow body.
[0044] Preferably, the hollow body serves as one electrode and has a polarity opposite to
that of a counter-electrode, which is also at least partly immersed into the mixture.
In a preferred embodiment of the invention, an electrode is placed on the outside
of the hollow body (outside electrode). The outside electrode may e.g. be an electro-conductive
mesh, preferably from metal. It preferably surrounds the entire hollow body.
[0045] Preferably the inside electrode is electrically connected to the hollow body. In
a preferred embodiment, the inside electrode doubles as a support, e.g. a hanger,
for the hollow body. For this purpose, part of the inside electrode may be hook-shaped.
The part of the inside electrode that acts as a support is preferably electrically
conducting. It is an achievable advantage of this embodiment of the invention that
in a convenient and reliable manner an electrical contact can be realised between
the inside electrode and the hollow body to ensure that both have the same polarity.
[0046] The preferred inside electrode is elongated, preferably extending at least through
part of the inside of the hollow body, more preferably extending through the entire
inside of the hollow body. E.g., if the hollow body is tubular, the preferred inside
electrode extends from one tube opening to the other tube opening. Preferably, the
hollow body is placed essentially vertically in the mixture. In this case, the preferred
inside electrode also extends vertically through the inside of the hollow body, the
bottom part of the inside electrode preferably supporting the hollow body in the mixture
and at the same time electrically contacting the hollow body.
[0047] The inside electrode may e.g. comprise an electro-conductive wire or a tube such
as a cannula, preferably from metal. In a preferred embodiment of the invention, the
inside electrode comprises a metal tube slid over a metal wire. The inside electrode
preferably has an outer diameter between 5% and 95%, more preferably between 50% and
90%, more preferably between 60% and 80% of the inner diameter of the hollow body
to be coated.
[0048] Preferably, the mixture of the polymer more specifically is a solution of the polymer,
in other words, the polymer is dissolved in a solvent. The invention, however, also
encompasses embodiments, in which the mixture is a colloid or a suspension, or more
generally, a dispersion, i.e. the polymer is merely suspended in a mixture medium.
The mixture medium, i.e. for example the solvent or the dispersion medium, preferably
is a liquid.
[0049] In a preferred method according to the invention, the polymer is electrically charged
in its mixed state, i.e. for example in its dissolved or dispersed state. The preferred
polymer is a cation in the mixture. However, the invention of course also encompasses
embodiments in which the polymer is an anion in the mixture. Preferably, during electrodeposition,
the hollow body acting as an electrode is oppositely charged to the polymer ion in
the mixture, more preferably negatively charged, acting as a cathode. Thus advantageously,
charged ions of the polymer can be attracted by the hollow body.
[0050] The preferred mixture medium comprises a protic solvent or a polar aprotic solvent.
The mixture may comprise a single mixture medium, preferably water, or a combination
of mixture media, one of which preferably is a polar aprotic solvent or a protic solvent,
preferably water. Advantageously, water is a good solvent for ions, inexpensive, and
well compatible with medical applications.
[0051] During deposition, in a preferred embodiment of the invention, the polymer precipitates
from the mixture due to charge destruction, preferably near the inside and/or outside
of the hollow body. For example, in an aqueous mixture charge destruction can be induced
by an increase of pH near the hollow body if the latter acts as a cathode, or a decrease
of pH near the hollow body if the latter acts as an anode. To adjust the pH of the
mixture, it preferably further comprises an acid or a base. Preferred acids include
inorganic acids, such as hydrochloric acid, as well as organic acids selected from
the group of monobasic or multibasic organic acids having 2 to 12 carbon atoms and
a first pKa value between 1 and 5, such as citric acid, lactic acid, malic acid, succinic
acid, mandelic acid, oxalic acid, tartaric acid, ascorbic acid, etc. Mixtures of inorganic
and organic acids, as well as salts of inorganic and organic acids (e.g., buffered
solutions) may be used as well to adjust the pH of the mixture.
[0052] A preferred polymer-layer is essentially pore-free. A preferred acid is a multibasic
acid, eg, citric acid. With this embodiment a particularly smooth layer of polymer
can be deposited on the electrode and/or pores in the polymer layer can be avoided
or at least reduced.
[0053] In a preferred embodiment of the invention, the bulk of the polymer mixture is acidic,
with a pH preferably between -1.0 and 6.5, more preferably between 1.0 and 6.0, more
preferably between 3.0 and 5.5. It is an achievable advantage of this embodiment of
the invention that polymers such as chitosan are soluble in the bulk of the mixture,
but can precipitate from the mixture near the hollow body if the latter acts as a
cathode, due to the increased pH near the cathode.
[0054] Preferably, the polymer is present in the mixture at a concentration between 0.01%
and 10%, more preferably between 0.1% and 1%, e.g. 0.33%. The voltage applied to the
electrodes for electrodeposition preferably is chosen from a range between 0.1 and
50 V (Volts), more preferably between 1 and 15 V, e.g. 10 V. The voltage preferably
is applied for between 0.1 and 300 s (seconds), more preferably between 1 and 60 s,
e.g. 15 s. The thickness of the layer achieved greatly depends on the time the voltage
is applied and can thus be adjusted by an appropriate choice of this duration. For
example, applying a voltage of 10 V for 15 s results in a chitosan layer of appr.
1 µm. As a general rule, higher polymer concentrations, as well as higher voltage
and/or longer application times result in thicker layers deposited. To achieve the
desired layer thickness, these parameters may be adjusted depending on the design
of the hollow body to be coated. However, very high voltages and/or long application
times may result in increased layer roughness and porosity, due to the formation of
gas bubbles during the electrolytic process. High polymer concentrations, on the other
side, result in increased mixture viscosities, thereby increasing the probability
of layer formation between the structural elements (i.e., coverings) of the hollow
body.
Brief description of the drawings
[0055] The invention is illustrated in greater detail with the aid of schematic drawings.
- Fig. 1
- shows schematically a set-up for manufacturing a mesh-like vascular stent according
to the invention with a chitosan coating by means of electrodeposition;
- Fig. 2
- shows schematically the container and the counter-electrode of the set-up of Fig.
- Fig. 3
- shows schematically the working electrode and inner electrode combination of the set-up
of Fig. 1;
- Figs. 4-10
- show photographs of vascular stents obtained with the set-up of Fig. 1 under various
conditions;
- Fig. 11
- shows an SEM image of a section of a coated stent; and
- Fig. 12
- shows schematically a cross-section through the wall of a polymer-covered stent.
Detailed description of embodiments of the invention
Example 1
[0056] A set-up 1 for coating the mesh-like wall of a hollow cylindrical stent 2 with a
chitosan layer both on the inside and the outside is schematically shown in Fig. 1.
It essentially comprises a cylindrical container 3 and an outer electrode 4, the stent
2, and an inner electrode 5 immersed into a chitosan containing solution 6 in the
container 3. The outer electrode 4 serves as the counter-electrode, being connected
to the positive pole 7 of a power supply 8, while the stent 2 and the inner electrode
5 are connected to each other and to the negative pole 9 of the power supply 8.
[0057] Fig. 2 shows the container 3 with the solution 6 and the outer electrode 4 of the
set-up 1. The container 3 is a vertical glass cylinder of circular cross-section and
a diameter of approx. 5 cm (centimetres) having an inner volume of approx. 100 ml
(millilitres), holding approx. 80 ml of solution 6. Immersed into the solution 6 is
a cylindrical grid of stainless steel which runs along the inside wall of the glass
cylinder on its entire circumference and acts as the outer electrode 4. The cylindrical
grid's diameter is approx. 4 cm, its mesh size is approx. 3 mm (millimeters). The
wires of which the grid is made have a thickness of approx. 0.5 mm. Moreover, a wire
10 of stainless steel connects the cylindrical grid with the outside of the cylindrical
glass container.
[0058] As shown in Fig. 3, the inner electrode 5 of the set-up 1 comprises an approx. 20
cm long stainless steel wire 11 with a diameter of approx. 0.3 mm, and a 5 cm long
blunt stainless steel cannula 12 slid over the wire 11. At the bottom 12, the wire
11 is bent in a hook-like fashion, so that the cannula 12 is supported at the bottom
12 of the wire 11 when the wire 11 is held in a vertical position, as shown in Fig.
1.
[0059] The stent 2 is a bare metal coronary stent made of stainless steel. The stent 2 has
the shape of a circular cylinder with a length of approx. 39 mm and a diameter of
approx. 1.55 mm. The stent's wall comprises of struts 16 with an essentially square-shaped
cross-section, the sides of the square having a length about 100 µm, which is consequently
also the width of the stent's 2 wall. The stent 2 is slid over the cannula 12, and
the hook-shaped part 14 of the wire 11 is large enough to also support the stent 2
when the entire arrangement 2, 5 is brought into a vertical position. The arrangement
of stent 2 and inner electrode 5 is placed into the solution 6 near the centre of
the cylindrical glass container 3 such that the stent 2 is fully immersed in the solution
6. The wire 11 is electrically connected to the negative pole 9 of the power supply
8. As both the cannula 12 and the stent 2 sit on the hook-shaped part 14 of the wire
11, they are, too, connected to the negative pole 9 of the power supply 8 and thus
have the same polarity. The outer electrode 4 is electrically connected to the positive
pole 7 of the power supply 8. Then, through the power supply 8, a voltage of 10 V
is applied between the counter-electrode and the metal wire for an appropriate amount
of time, e.g. 15 s.
[0060] Afterwards, the wire 11 is disconnected from the power supply 8 and the arrangement
of wire 11, cannula 12, and stent 2 is removed from the solution 6 using tweezers
and placed in a hanging position in a bath of distilled water (pH 7). Further by means
of the tweezers, the cannula 12 is gently removed while the stent 2 remains sitting
on the wire 11. Then, the bath of distilled water is agitated (by means of stirring
at 200 rpm) for approximately 2 min (minutes) to wash the chitosan-coated stent.
[0061] To make the chitosan coating visible for inspection, the chitosan is subsequently
stained by immersing it into a staining solution. The staining solution comprises
a 0.1% aqueous solution of indigocarmine. After an incubation time of approximately
1 min in the staining solution, the stent 2 is removed and dipped in distilled water
for 10 s and then left hanging to dry at room temperature under vacuum. Finally, the
stent 2 is removed from the wire 11 and is kept in a dust-free environment. In a variation
of this procedure, the cannula 12 is kept on the wire 11 during the entire procedure
above and is only removed from the stent 2 together with the wire 11 at the end of
the procedure.
[0062] Figs. 4 to 10 show the result of various coating experiments under different conditions.
In all experiments, a voltage of 10 V was applied for 15 s. As can be seen from the
experiments, the diameter of the cannula as well as the choice of acid have an important
impact on the coating obtained. In Figures 4 and 5, citric acid was used as the acid
in a solution 6 of the following composition: 0.33% of chitosan in 1% citric acid
solution mixed with N-methyl pyrrolidone (1:1). The cannula 12 had a diameter of 1.18
mm (Fig. 4) and 1.38 mm (Fig. 5), respectively. A good coating both on the inside
and the outside of the stent 2 was observed.
[0063] In contrast, a 0.81 mm cannula 12 under otherwise identical conditions yielded merely
a good outside coating but no observable coating on the inside (Fig. 8). Similarly,
when instead of a cannula 12 only a 1.15 mm wire 11 was used as the inside electrode,
only a weak and irregular coating on the outside and no observable coating on the
inside was achieved (Fig. 7). The effect of the choice of acid in the solution 6 is
demonstrated in Fig. 8, where under otherwise identical conditions to those of Fig.
4 a solution comprising 1% acetic acid was used instead of citric acid. No coating
was observable under these conditions.
[0064] Figs. 9 and 10 show control experiments in which no inner electrode 5 was present
at all. Rather, the stent 2 was supported at its top by the hook-shaped end 14 of
the metal wire 11 so that the wire did not traverse the inner of the stent 2. In a
chitosan solution that contained acetic acid (the composition comprising 0.33% of
chitosan in 1% acetic acid solution mixed with N-methyl pyrrolidone (1:1)), no coating
was observed at all while when citric acid was used (the composition comprising 0.33%
of chitosan in 1% citric acid solution mixed with N-methyl pyrrolidone (1:1)) there
was a weak coating only on the outside of the stent.
[0065] As can be seen from Fig. 11, which shows a scanning electron-micrograph of a section
of a stent 2 obtained under the conditions of example 1, the coating obtained is very
even, without any pores or spikes. In particular, no webbings can be observed that
extend into the apertures between the webs. Finally, by means of a schematic cross-section
through the stent 2, Fig. 12 illustrates that the local thickness t of the coating
layer 15 on a structural element 16 of the wall is measured in the direction perpendicularly
to the surface of the coated structural element 16. The structural element 16 has
a part 17 on the inside of the hollow body and a part 18 in the outside of the hollow
body. It is entirely coated with the coating layer 15 in the sense that there is no
gap between the coating of the structural element on the inside part 17 and the coating
of the structural element on the outside part 18. Rather, the coating layer 15 continuously
extends on the structural element 16 from the inside to the outside of the hollow
body.
Example 2
[0066] This is an example of incorporating an additive such as a drug by coating from a
chitosan/additive susupension 6. Diflunisal is used as a model drug. The stent 2 is
coated following the steps as described in Example 1 above, except that the chitosan
solution 6 comprised of 0.33% chitosan, 2% citric acid, and 0.33% diflunisal which
was suspended in the chitosan solution using an Ika T25 Ultra-Turrax homogenizer at
24000 rpm for appr. 30 s.
Example 3
[0067] This is another example of incorporating an additive such as a drug by coating from
a chitosan/additive solution 6. Diflunisal is used as a model drug. The stent is coated
following the steps as described in Example 1, except that the chitosan solution 6
comprised of 0.33% chitosan, 1% citric acid/N-methylpyrrolidone (1:1), and 0.33% diflunisal.
Example 4
[0068] This is yet another example of incorporating an additive such as a drug by first
forming a layer of the additive, followed by coating from a chitosan solution 6. Ditlunisal
is used as a model drug. The stent 2 as used in Example 1 is dip-coated in a 5% solution
of diflunisal in acetone, and after drying for approx. 5 min, coated following the
steps as described in Example 1, except that the chitosan solution 6 comprised of
0.33% chitosan and 2% citric acid.
Example 5
[0069] This is yet another example of incorporating an additive such as a drug by first
coating from a chitosan solution 6, followed by immersion in a drug solution. Diflunisal
is used as a model drug. A stent 2 is coated as described in example 1, followed by
immersion in a solution of 0.5% diflunisal in 0.1 N sodium hydroxide for approx. 10
min. Afterwards, the stent 2 is washed thorougly in distilled water, dried at room
temperature and stored in a dust-free container.
[0070] The features described in the above description, claims and figures can be relevant
to the invention in any combination. The reference numerals in the claims have merely
been introduced to facilitate reading of the claims. They are by no means meant to
be limiting.